ISSN 2326-7291
International Journal of Public Health and Epidemiology ISSN 2326-7291 Vol. 15 (1), pp. 001-011, January, 2026. Available online at www.internationalscholarsjournals.org © International Scholars Journals
Full Length Research Paper
Post-Discharge Outcomes of Severe Acute Malnutrition: A Multi-Country Analysis of Long-Term Mortality
Paluku Bahwere1,3*, Angella Mtimuni3, Kate Sadler2,3, Theresa Banda3 and Steve Collins3
1Centre of Research in Epidemiology, Biostatistics and Clinical Research, Free University of Brussels, Brussels, Belgium
2Feinstein International Center, Tufts University, Medford, MA 02155, United State
3Valid International, 35 Leopold Street, Oxford, OX4 1TW, United Kingdom.
Accepted 23 November, 2025
The effectiveness of the community based therapeutic care (CTC) in treating severe acute malnutrition (SAM) has been demonstrated. However, there is still resistance from some policy makers and donors to invest into this cost-effective intervention. The mortality rate ratio (MRR) calculated by dividing the observed deaths after discharge by expected deaths was used to compare survival of 1,670 children discharged from the Dowa CTC from August 2002 to May 2005 and that of other cohorts reporting on long term survival of children after treatment of SAM retrieved from literature. A MMR of 1.1 (0.9 to 1.4) was observed for the Dowa CTC cohort while the MMR of 2.7 (1.3 to 4.9), 5.5 (3.9 to 7.6) and 20.0 (11.0 to 33.4) were observed for studies retrieved from the literature. Data showed that the survival of children who defaulted was worse than that of those who were discharged cured, and that of children treated at home after stabilisation or directly was better than those treated as inpatient until exit from the programme. The study outlines the need of using MMR when reporting on long term survival after SAM treatment and suggests that CTC should be included in the package of interventions with high potential for accelerating the progress towards reaching Millennium Developmental Goal four.
Key words: Severe acute malnutrition, children, long term, survival, mortality ratio.